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LAND USE PERMIT APPLICATION -Burnett County, WI r <br /> • a � b <br /> Applicant Complete All Sections Below This Line <br /> Permit Types and FeestPlease,check appropriate boxes), o <br /> C <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 \ o <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 °< <br /> Driveways/&Campground Structures $125 P WI State Statute 59.692(ly)Structures $350 0 <br /> Filling/Grading $150 Boathouse $500 <br /> 0 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 <br /> ;v• <br /> NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> *Communication Towers,Camping Permits&Signs require a different application form,see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. 0 <br /> 0 a <br /> Property Owner's Name: <br /> � { 0 <br /> Property Owner's Mailing Address: <br /> City State Zip <br /> � n <br /> Property Site Address:-<_ p - —1J <br /> Contact's Telephone Number: (CJ 2 Q� � T-7 0 a <br /> t <br /> Contact's Email: c t^r i�(�� ` � I�" C,`C CLAA [•C5m <br /> **If staff has a question about this application,you will be d'ottacted via email. Make sure your email address is <br /> legible and your email provider will accept emails from the following address:@BumettCountywI.gov <br /> Legal Description of Property: m,53` d <br /> Section#:- 1\0 _Town#:_4]L_N Range#: _W Town of-T16 fq La-AL'o <br /> *Attach additional page if needed for lengthy description OR attach a copy ft of the deed OR attach tax system property page.* cn <br /> Tax ID#(1-5 digit number;found on tax statement): ( �� 1 I g <br /> Proposed Use of Structure/Addition: j�� � f c jy -�0L-� <; .� 6 <br /> Anticipated Start Date: (HomelCabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: Sewer Installer: Q W <br /> N <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY °m <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: z z <br /> �1/5 erti+i js {ter ate s{Mr'?IPe co H1-�e,<!' A <br /> %I. < °� <br /> /Il©rL <br /> 7� � Gt S �D �'!G Gvt4F► l/1 Tel� rn <br /> oFee Rec: <br /> L/ z Check#: 69-5PA <br /> r <br /> < <br /> X <br /> CL <br /> Date of staff site visit: ✓C 7i0Z� Initials of site visit staff: /� a cn W n <br /> APPROVED BY LAND SERVICES OFFICIAL: DATE: <br /> m % o <br /> N n C" <br /> UPON APPROVAL: APPL CANT MUST POST COPY OF 0 <br /> CD <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT <br /> Page 1 of 5 <br /> Burnett County, WI Land Use Application—Rev 11/2024 <br />